Sequencing of this case has now revealed that it indeed does carry the Pandemic "M" gene that is being commonly detected in many of the various flu strains in current circulation.

[Previously it was reported in ProMED-mail post: Influenza (91): Canada (ON) H1N1v, human case 20120926.1311060 that it had not been confirmed that the M gene of the pandemic H1N1 virus, which is also present in the swine flu viruses that have been causing human infections in the USA this summer 2012, was present in the Canadian isolate. In fact, the complete sequence had been obtained, and the relevant data are presented below. - Mod.CP]

* PCR and sequencing results of HA and NA showed that this virus is an H1N1 subtype, which is closely related to H1N1 swine triple reassortant viruses identified in the United States in 2011 and 2012

* Sequencing revealed that this H1N1 carries the M gene of influenza A(H1N1)pdm09, as was found in the last 2 documented cases of H1N1v infection, in Wisconsin (December 2011) and Missouri (reported September 2012).

Note should be made on the large percentage of H1N1 that has been circulating in Brazil, where it has caused a total of 330 deaths so far this year.

Influenza Update Number 169---------------------------Summary--------- Seasonal influenza transmission has not been picked up yet in the northern temperate zone. Most countries in this zone have started or are yet to begin seasonal reporting.-- In the tropical areas most countries are reporting low or decreasing trends of influenza detections. The exceptions are Nicaragua in the Americas, and India and Thailand in Asia.-- Influenza activity decreased in most of the temperate countries of the southern hemisphere. Australia, Chile, New Zealand, Paraguay and South Africa continue to report declines in influenza indicators. On the other hand, Argentina has reported some late influenza activity.-- The World Health Organization (WHO) has recommended the influenza vaccine composition for use in the 2013 southern hemisphere influenza season following technical consultations in September 2012.

This next extract gives a clear picture of the complete state of H3N2v, including all hospitilizations resulting from it, since July in the US.

Since July 2012, 305 cases of infection with influenza A (H3N2) variant (H3N2v) virus containing the influenza A (H1N1)pdm09 M gene have occurred in multiple U.S. states, primarily associated with swine exposure at agricultural fairs (1). In Ohio, from 28 Jul to 25 Sep 2012, a total of 106 confirmed H3N2v cases were identified through enhanced surveillance.

Whereas most H3N2v patients experienced mild, self-limited influenza-like illness (ILI), 11 of the Ohio patients were hospitalized, representing 69 percent of all H3N2v hospitalizations in the United States. Of these hospitalized H3N2v patients, 6 were at increased risk for influenza complications because of age or underlying medical conditions, including the only H3N2v-associated fatality reported in the United States to date.

The link below will take readers to the lates WHO flu report previously mentioned above, however of interest in this particular report is at the end where the vaccine contents for 2013 contain the same contents as that for the Northern Hemisphere.

Following the WHO Consultation on the Composition of Influenza Virus Vaccines for the Southern Hemisphere 2013, from 17 to 19 September 2012, it was recommended that the influenza vaccines for the southern hemisphere 2013 season contain the following viruses:

For the trivalent vaccine:

an A/California/7/2009 (H1N1)pdm09-like virus;an A/Victoria/361/2011 (H3N2)-like virus;a B/Wisconsin/1/2010-like virus;This is the same composition as that recommended by WHO for the vaccine for the northern hemisphere 2012-2013 season.

For the quadrivalent vaccine containing two B viruses, it is recommended to include the above three viruses and a B/Brisbane/60/2008-like virus.

Influenza figures for New Zealand for the period from the 17th of September to the 23rd of September 2012 are as follows.

INFLUENZA WEEKLY UPDATE2012/38: 17 – 23 September 2012The national influenza surveillance system in New Zealand is an essential public healthcomponent for assessing and implementing strategies to control influenza. This reportsummarises the data collected on influenza-like illness (ILI) from sentinel general practice(GP) surveillance and non-sentinel surveillance for week 38 (17 – 23 September 2012).Summary· ILI through sentinel surveillance was reported from 19 out of 20 District Health Boards(DHB) with a national consultation rate of 21.0 per 100 000 (80 ILI consultations).· A total of 290 swabs were received from sentinel (8) and non-sentinel (282) surveillance.· 46 viruses were identified: A (Not subtyped) (19), A(H3N2) (13), B (Lineage notdetermined) (12), and A(H1N1)pdm09 (2) including one A/California/7/2009 (H1N1)-like virus.In week 38, ILI consultation rate has decreased below the baseline. The proportion of positiveinfluenza samples has also decreased. Influenza A(H3N2) viruses remain the predominantvirus in many regions. These viruses do not appear to demonstrate a major antigenic drift.

Comment:The 2012 influenza season started in week 21 (ending 27 May) when the detection rate from the Viral Watch Programme rose to 21% and peaked in week 33 (ending 19 August) at 68.4%. This year to date (week 37, ending 16 September), 1776 specimens have been received from Viral Watch sites in all nine provinces. Influenza A (unsubtyped) was detected in 11 patients, influenza A(H1N1)pdm09 in four, influenza A(H3N2) in 408, and influenza B in 286 patients.

In this time period 3794 patients with SARI have been tested at the 5 sentinel sites, and influenza A(unsubtyped) was detected in five patients, influenza A(H1N1)pdm09 in one, influenza A(H3N2) in 113, and influenza B in 103 patients in all four provinces with sentinel sites. There are a number of specimens collected during week 37 awaiting results.

Please note that these data are from sentinel sites and reflect trends in the areas with participating sites. Numbers reported reflect numbers of patients enrolled into the surveillance programmes and do not reflect total numbers of patients in the community.

The CDC has released the results of a study covering several years that has looked at the issue of swine being displayed at county fairs and their interaction with humans in terms of the bi-directional spread of influenzas.

This is a good study and goes some way to explaining many of the questions that have arisen from this years outbreak of H3N2v that has been associated with those fairs.

AbstractAgricultural fairs are associated with bidirectional, interspecies transmission of influenza virus A between humans and pigs. We examined pigs exhibited at agricultural fairs in Ohio during 2009–2011 for signs of influenza-like illness and collected nasal swab specimens from a representative subset of these animals. Influenza virus A was recovered from pigs at 12/53 (22.6%) fairs during the 3-year sampling period. Pigs at 10/12 (83.3%) fairs from which influenza virus A was recovered did not show signs of influenza-like illness. Hemagglutinin, neuraminidase, and matrix gene combinations of the isolates were consistent with influenza virus A concurrently circulating among swine herds in the United States. Subclinical influenza virus A infections in pigs at agricultural fairs may pose a risk to human health and create challenges for passive surveillance programs for influenza virus A in swine herds.

Sequencing revealed that this H1N1 carries the M gene of influenza A(H1N1)pdm09

The HA gene was found to have nucleotide sequence homologies of:• 98.8 percent to the HA of the H1N1v reported in Missouri earlier this month

Further investigations have revealed that there are currently three serotypes currently in circulation in Minnesota and at least two serotypes in current circulation in Northern America, apparently something that has not previously been seen before, as extracted, below.

At the risk of being repetitive, this is the type of general viral load distributed throughout the community that lends itself to increased opportunities for these viruses to naturally reassort themselves and potentially present the population with a new pandemic threat.

Moreover, media reports suggest that the Ontario case may have had exposures in the United States, suggesting H1N1v is circulating in Minnesota, which is in addition the 4 confirmed H1N2v cases and 4 confirmed and 1 probable H3N2v cases. Thus, all three serotypes appear to be con-circulating in Minnesota, while 2 or more of each sub-types are circulating in North America in 2012.

The USDA has released addition recent H3N2v swine sequences. Included were sequences for the internal genes (PB2, PB1, PA, NP, NS) for 3 June, 2012 isolates from Ohio.

This final paragraph, again asks more questions that there are yet answers for, and again, it involves patient zero from the West Virginia day care centre, who developed influenza in hospital under unusual and as yet unexplained circumstances.

Therefore, the presence of both changes in the June Ohio swine raises concerns that this combination will increase the potential for human adaptation and transmission. However, these isolates, like the first 10 human cases in 2011, have an NA lineage found in H1N2v swine, but all 2012 human cases (58 public sets of sequences) have had an N2 lineage found in H3N2v swine and first seen in human cases in the sequences from the 2011 West Virginia day care outbreak in Mineral county (A/West Virginia/06/2011 and A/West Virginia/07/2011).

Well, if nothing else, all the attention that the flu virus is getting from all sorts of sources, one thing is certain, and that is that public awareness is growing and that has to be a good thing indeed.

Here is another example of how even MSM are also addressing this important public health issue.

HEALTHDAY NEWS - The only thing predictable about the flu is its unpredictability, U.S. health officials said Thursday, as they urged virtually all Americans to get vaccinated for the coming season.

Even though last year's flu season was one of the mildest on record, that's no sign of what this season will bring. It was only two years ago, officials noted, that the H1N1 pandemic flu swept around the world, sickening millions.

"The last several years have demonstrated that influenza is predictably unpredictable," Dr. Howard Koh, assistant secretary for health at the U.S. Department of Health and Human Services, said during a morning news conference.

Back to the matter of the new coronavirus that has been detected in Saudi Arabia.

We now see this article from Manilla, which at this point in time could be a little premature as there have only been the two cases, seperated by three months and with no evidence of H2H contaigen.

I do think that this an over reaction, with the possibility of desensitizing the population to travel risks when there might actually be a real possibility from some other bug at a different time.

A sort of "its the wolf" cry, if you like.

SARS-Like Virus FearedQuarantine Officers Closely Monitor Passengers From Middle EastBy ANJO PEREZSeptember 26, 2012, 6:37pmMANILA, Philippines --- The Manila International Airport Authority has ordered a tight watch on passengers arriving from the Middle East who might be possible carriers of a new SARS-like virus detected there recently.

Although the Department of Health (DOH) has yet to release a statement on the newly discovered respiratory virus, the Human Quarantine personnel have been alerted to be on the close watch for passengers who might be arriving with symptoms of the flu.

Its a long weekend here this weekend, so just taking a break from the usual.

Thank you for your concern.

cheers

arkay

Quoting: arkay

glad to hear it you had me worried for a while good to see you back, you are doing amazing things with this thread

Quoting: Anonymous Coward 1457510

Thank you UK anon.

But as you know, its not all me, this is a work of the people, people who are prepared to dedicate their efforts for no reward other than to know that what they do, might help someone, somewhere and some day.

To me thats the most noble thing a person can do for another and to everyone, all I can is acknowledge that and to offer my deepest appreciation and admiration to you all.

Yesterday we reported that Manilla had begun to watch visitors at airports for symptoms of the newly detected coronavirus, in Sauda Arabia.

Today we now see that Vietnam is also initiating similar actions.

These two countries have been constantly plagued with regular problems with H5N1 , so its probably no surprise that they are being especially sensitive to this potential threat.

Tuesday, Oct 02, 2012, Posted at: 15:24(GMT+7)

Vietnam alert to new strain of Coronavirus Special quarantine cells at international border gates have been asked to check body heat of incoming passengers so as to detect and prevent a new SARS-like virus ‘Coronavirus’ from entering the country, said Nguyen Van Binh, head of the Department of Preventive Health, on October 1.

The World Health Organization (WHO) has already confirmed two severe infections and one death from the deadly virus.

Quarantine teams at International Airports in Ho Chi Minh City, Noi Bai and Da Nang have been asked to detect tourists’ body heat and medical condition.

Two more people died of swine flu in the state in the past week even as seven new confirmed cases were registered, an update from the state Health Department’s epidemics division said Monday. The H1N1 death toll for this year has reached 14 out of 43 confirmed cases.

The CDC has released a large series of H3N2v sequences from August, 2012 cases, increasing the number of July/August sets to 90. Included were two sets of sequences from two cases in Michigan collected on August 16. Sequences from one case, A/Michigan/20/2012, cover seven of the eight gene segments (all except NS), while the second set, A/Michigan/19/2012, from an adult (54M), covered PB1 and PA. The shared sequences were virtually identical suggesting all 8 gene segments match. Both PB1 sequences had E618D and were closely related to sequences from 2010 human cases, as was seen in recent swine sequences from June collections in Ohio (A/swine/Ohio/1/2012, A/swine/Ohio/6/2012, A/swine/Ohio/7/2012).

This final paragraph carries with it some concern about the progressive spread of these viruses that should be watched closely.

The limited number of human cases with the N2 that is widespread in swine suggests that jumps from swine to human are relatively rare, but the two newly released sequences from Michigan raises concerns that the spread of this novel constellation may be increasing.

It appears that Nepal is having to deal with a new and serious outbreak of H1N1, the first since 2009.

To date there have been 24 deaths from this outbreak.

Swine flu virus, called pandemic influenza A(H1N1)pdm9, has been detected in the Nepali capital and 3 other districts outside the capital, doctors at the Sukraraj Tropical & Infectious Disease Hospital in Kathmandu said Wednesday [3 Oct 2012]. Doctors confirmed the outbreak of swine flu virus [infection] after the virus was detected in blood samples collected in the capital and the country's mid-western districts of Chitwan, Sindhuli and Khotang. Prior to this outbreak, H1N1 virus was seen in Nepal in 2009.

Doctor Gita Shakya, director of the National Public Health Laboratory of Kathmandu, said that people don't have to be worried about the disease as it can be cured if found in the preliminary stage. Dr. Shakya said the reason behind the resurgence of the virus in Nepal is that several districts of the country have recently been suffering from [an unidentified] viral fever.

Doctors said so far over a dozen people died due to viral fever outbreaks in Nepal. "Of the total 24 deaths from viral fever, some of them might have died due to late diagnosis of the swine flu virus," Dr. Shakya said.

The CDC has released its updated US and Worldwide influenza statistics for the period up to the 20th of September 2012.

This article talks more specifically on the topic of the H3N2v outbreak that has occurred in the US, but continues to hold with the previously held stance on the spread of this virus.

During the period 20 May to 22 Sep 2012, the United States experienced low levels of seasonal influenza activity overall; however, more seasonal influenza viruses were detected than in the summer months of previous years. Influenza A (H1N1)pdm09 (pH1N1), influenza A (H3N2), and influenza B viruses were detected worldwide and were identified sporadically in the United States. In July 2012, influenza A (H3N2) variant viruses (H3N2v) were 1st detected in Indiana, and since 12 Jul 2012, a total of 306 cases have been reported from 10 states. This report summarizes influenza activity in the United States and worldwide since 20 May 2012.

This next article relates to the detection of the new novel coronovirus in Saudi Arabia.

This is a remarkeble article as it reveals the protocols that are put into play when a new virus is detected.

The process is thorough and far reaching and readers should take the time to read and appreciate the efforts and reasons behind them that work to detect the source, and possible contacts and how the spread of this or any new threat is as much as possible limited and confined.

The British HPA have to be congratulated at the speed that they acted with, not just in instigating all the above measures but also with the actual rapid sequencing that they undertook in record time.

If their standards could be replicated elsewhere around the world there is no doubt that we would suffer much less from these contaigens.

It is also excellent news that at this stage this novel coronovirus appears to be rare in terms of human infection and even with its H2H contaigen, but of concern remains the question of where the reservoir is for this deadly bug.

Clearly there will be a lot of effort being currently expended by some very brave specialists in their efforts to locate it and hopefully eliminate it before it does transmit into our general population.

Rapid communicationsThe United Kingdom Public Health response to an imported laboratory confirmed case of a novel coronavirus in September 2012--------------------------On [22 Sep 2012], a novel coronavirus, very closely related to that from a fatal case in Saudi Arabia 3 months previously, was detected in a previously well adult transferred to intensive care in London from Qatar with severe respiratory illness. Strict respiratory isolation was instituted. Ten days after last exposure, none of 64 close contacts had developed severe disease, with 13 of 64 reporting mild respiratory symptoms. The novel coronavirus was not detected in 10 of 10 symptomatic contacts tested.

There has been a consistant and ongoing battle against H5N1 in this country and its stories like these that give us some insight into some of the causes for their ongoing and expensive problems.

Here smuggling is in the spotlight.

Smuggled poultry floods Vietnam

Updated : Wed, October 3, 2012,1:05 PM (GMT+0700)

Chicken smuggled in a northern province

Since September the smuggling of poultry from China into Vietnam has increased remarkably, worsening the risk of the spread of avian flu and damaging domestic traders, said the Animal Husbandry Department

Nguyen Thanh Son, deputy head of the department, under the Ministry of Agriculture and Rural Development, delivered this news at yesterday’s meeting held by the National Steering Board for Avian Flu Prevention and Control to discuss the epidemic situation.

“Every day three or four trucks carry a large quantity of smuggled chicken to Ha Vy poultry market in Hanoi,” Son said.

Besides the smuggled chickens, including those meant for breeding, were duck and swan eggs that were about to hatch, he added.

Deputy Minister of Agriculture and Rural Development Diep Kinh Tan called on local authorities at the northern border to tighten control to prevent poultry from being smuggled into Vietnam, especially via the Mong Cai border gate and Quang Yen Market in Quang Ninh Province.

The market and the border gate account for as much as 90 percent of the volume of chicken smuggled into Vietnam, Tan said.

Good news from the CDC who are reporting that there have been no new cases of H3N2.

CDC reports no new variant H3N2 casesNo new variant H3N2 influenza infections were reported last week, keeping the national total at 306, the US Centers for Disease Control and Prevention (CDC) said today in its weekly influenza update.

A 31-year-old woman from Baramati died of H1N1 virus on Thursday. She was was suffering from cold, cough and fever since September 24.

She was shifted to city’s Noble Hospital from Niramaya Medical Foundation and Research Centre in Baramati after she complained of breathlessness on September 30. Her throat swab was taken on October 2 which tested positive for H1N1 virus on Thursday.

Tamiflu tablet was given to her on October 2 but by then she was already critical, said a statement issued here. She was admitted to the isolation ward at Noble Hospital on Thursday where she succumbed to the virus.

This is the 17th progressive swine flu death reported by Pune Municipal Corporation since April this year.

In another case, a girl has also passed away with what is suspected to be swine flu, also in India.

Suspected swine flu death in Gondia district

A 12-year-old girl, Priyanka Kawale of Wadegaon village in Tiroda Tehsil died after suspected swine flu like symptoms on October 3. According to in charge of primary health centre, Wadegaon, Dr Abhay Patil, the girl could have died due to some other viral infection.